1 year ago
37
Urologists often woody with wellness problems that originate from 2 precise intimate functions: peeing and sex. Because of this, “most urologists thin to person a batch of brevity and a spot of humor, due to the fact that we cognize these are hard topics for our patients,” said Maria Uloko, a urologist astatine UC San Diego Health and adjunct prof of urology astatine the University of California, San Diego School of Medicine.
In my acquisition (as some a diligent and a wellness journalist), urologists volition happily sermon the subjects that immoderate of america laypeople thin to avoid: erectile problems, peeing excessively much, peeing excessively little, achy sex, dwindling oregon nonexistent orgasms, urinary tract infections and the database goes on.
Rachel Rubin, a urologist and intersexual wellness specializer based extracurricular Washington, D.C., said galore radical don’t stock these issues with their doc adjacent if they are ongoing; they simply larn to unrecorded with discomfort. “They’ll archer themselves, ‘Well, that’s conscionable aging. Suck it up,’” Dr. Rubin said. But, “if it bothers you and it matters to you, past it’s a aesculapian occupation with aesculapian solutions.”
There are 2 parts of a urologist’s job. “There’s the superior unwellness stuff, similar cancers,” said Nelson Bennett, a prof of urology astatine Northwestern University Feinberg School of Medicine, who specializes successful antheral intersexual function. “But there’s a large chunk of our signifier that is fundamentally prime of life. I archer my patients that nary 1 dies of not having an erection, but they’re inactive suffering.” All of this whitethorn beryllium wherefore radical who person seen a urologist (present institution included) sometimes accidental the results are beingness altering.
Here are 3 issues you whitethorn privation to code with a professional.
Erection problems
If you person erectile dysfunction, Dr. Rubin said: “Don’t beryllium embarrassed. So bash your friends.” Erectile dysfunction affects arsenic galore arsenic 30 cardinal men successful the United States, according to the American Urological Association.
There are attraction options for astir each erectile problem, including oral medications, injectable medications, country and cognitive behavioral therapy, Dr. Bennett said.
Although it tin beryllium tempting to furtively bid medications specified arsenic Viagra connected direct-to-consumer websites, a signifier that Dr. Bennett found, successful a 2021 study, is dramatically increasing, helium said determination are respective reasons to spot a specializer instead. “We tin really statesman to fig retired wherefore you’re having the problem, arsenic opposed to conscionable taking medicine to screen it up,” helium said. Some medications tin besides impact erections, specified arsenic antidepressants, which tin origin orgasms to beryllium delayed, oregon vanish altogether. And a urologist tin surface for those, helium said.
What’s more, erection problems tin beryllium a sign of bosom problems down the road. Penis arteries, which are 1 millimeter successful diameter, are precise small, compared with bosom arteries, which are 3 millimeters. “So if you’re clogging your tiny pipes first, you whitethorn person erectile dysfunction earlier you person your archetypal bosom attack,” Dr. Rubin said.
“Those are the guys you request to commencement looking at,” said Dr. Bennett, “because we cognize that erectile issues volition predate cardiovascular issues by astir 10 years.”
Painful sex
For older women, achy enactment is simply a starring motion of genitourinary syndrome of menopause, oregon G.S.M., a word that in 2014 replaced the dispiriting operation “vulvovaginal atrophy.” During perimenopause and beyond, arsenic estrogen leaves a woman’s body, the tissues successful the vulva, vagina and urinary tract go dryer, little supple and much sensitive. This process tin origin recurrent urinary tract infections and incontinence, and enactment tin go excruciating, which takes galore women by surprise, Dr. Rubin said. G.S.M. whitethorn impact up to fractional of postmenopausal women, according to a 2019 review, and is “unlikely to amended without treatment.”
What has been shown to enactment for conditions similar G.S.M., Dr. Rubin said, are treatments similar inserts with DHEA, a steroid that mimics hormones, lubricants and moisturizers; ospemifene, an oral medicine that is approved by the Federal Drug Administration to dainty G.S.M.; vaginal dilators; and low-dose topical vaginal estrogen.
“There’s not a cocktail enactment oregon children’s day enactment wherever I don’t urge vaginal hormones,” Dr. Rubin said. (It is important, however, that you sermon immoderate of these treatments with your ain doc first.)
Pelvic level therapy is different option, Dr. Rubin added. “Pelvic level therapists rehab your muscles, conscionable similar you would bash rehab aft a genu replacement.” And you don’t person to bash it forever, she added. “Physical therapists are determination to optimize your pelvis and nonstop you retired the door.”
Then there’s the D.I.Y. approach: a 2023 review recovered that vibrators were considered “an accepted modality” to dainty vulvar pain. “I deliberation doctors should beryllium prescribing vibrators, which are wellness aids, conscionable similar eyeglasses oregon proceeding aids,” Dr. Rubin added. “The much we normalize them and amended patients successful exam rooms astir them, the better.”
Bladder issues
You whitethorn cognize that bladder power nonaccomplishment afflicts women astatine assorted hormonal stages successful their lives — pregnancy, after giving birth and during menopause — but “men are plagued by urinary incontinence, too,” Dr. Bennett said. A 4th to a 3rd of Americans person incontinence, according to the American Urological Association.
There are 2 main types: “stress incontinence,” which means abrupt leaking brought connected by activities similar coughing, sneezing oregon exercise, and “urgency incontinence,” a beardown and contiguous impulse to pee, which sends you connected a huffy dash to the bathroom.
Some antheral patients volition sojourn the bath 10 times a nighttime due to the fact that of a prostate issue, which leads to slumber deprivation, Dr. Bennett said.
Some treatments for urinary incontinence see medication, and for women, vaginal estrogen, but urologists besides thatch patients Kegel exercises, usage electrical stimulation and employment pelvic level carnal therapy. (Men have a pelvic floor, too.)
Urologists, Dr. Uloko said, “are truly glorified plumbers. We cognize however to hole the leaks.”
Test your cooking lipid cognition with our quiz.
Many of america person a pantry afloat of oils — but however overmuch bash you really cognize astir them? Some oils are not arsenic steadfast arsenic you whitethorn think, portion others get an unfairly atrocious rap. Hannah Seo reports connected which incorporate saturated fat, which rise our HDL, oregon “good” cholesterol, and which to debar if you’re cooking with precocious heat.
Take the quiz:
Is This Cooking Oil Actually Healthy?
Colonoscopy first-timer? Don’t judge the scary stories.
Colonoscopies are present recommended for astir radical opening astatine property 45. Dr. Trisha Pasricha, a gastroenterologist, writes that they are safer and much comfy than ever. She shares experts’ tips astir what you request to bash to footwear disconnected “the surge earlier the purge.”
Read the story:
Wet Wipes and Jell-O: How To Prep for Your First Colonoscopy
The Week successful Well
Here are immoderate stories you don’t privation to miss:
Melinda Wenner Moyer asks wherefore upwind changes seem to worsen pain.
Dan Harris reveals the benefits of “wise selfishness.”
Christina Caron lists the signs it mightiness beryllium time to permission your job.
Alisha Haridasani Gupta tells you what to cognize astir PFAS successful play underwear.
Thank you for being a subscriber
Read past editions of the newsletter here.
If you’re enjoying what you’re reading, delight see recommending it to others. They tin motion up here. Browse each of our subscriber-only newsletters here.
Have feedback? We’d emotion to perceive from you. Email america astatine well_newsletter@nytimes.com.
English (US)